Q4196
CPT/HCPCSPuraply am, per square centimeter
Physician Fee Schedule
Facility
Medicare Payment
$80.11
Submitted Charge$239.76
Medicare Allowed$100.71
Providers24
Beneficiaries40
Total Services3,083
Office
Medicare Payment
$83.33
Submitted Charge$224.49
Medicare Allowed$104.68
Providers1,117
Beneficiaries3,135
Total Services166,288.4